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NUR 336 final Questions With Complete Solutions
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NUR 336 final Questions With Complete Solutions
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NUR 336 final Questions With Complete SolutionsAn ileostomy puts a client at risk for what? Correct Answers
fluid and electrolyte imbalances
Assessment of PIV & possible complications Correct Answers
-Inspect: redness, swelling, streaking, or drainage
-Palpate: area around site and along vein for any pain, firmness,
swelling, or blanching, note skin temperature
-Educate client to report changes at site
-PIV usually replaced every 72 to 96 hours
-Populations at risk for infection: pediatrics, clients receiving
hypertonic, acidic, irritating fluids, or clients who have fragile
veins
-Phlebitis: characterized by pain, increased skin temp, and
redness along vein
-Infiltration: characterized by edema, pallor, decreased skin
temp around site, pain
-Extravasation: pain, stinging, burning, swelling, redness at site
Basics to preparing a sterile field Correct Answers On clean
and dry surface, inspect integrity and expiration date
Open first flap away from you, maintain 1 inch borders
Drop items in 6 inches above sterile field
Describe assisting another member with sterile gowning Correct
Answers -Lift gown from inside just below neckline
-Keep hands on outside cuff of neck and shoulder areas,
assistant opens gown for surgical team member to insert arms
-Insert hands to seam of inside cuff
,-Non Sterile assistant reaches inside gown at shoulder level and
pulls gown over shoulders and secures ties (also assists with
wraparound)
Describe independent surgical gowning Correct Answers -
Sterile gown on sterile field (folded inside out)
-Lift gown from inside just below neckline
-Step back from field, letting gown unfold away from body
-Work arms into sleeves holding hands and arms up
-Insert hands to seam of inside cuff
-Assistant or circulating nurse reaches inside gown at shoulder
level and pulls gown over shoulders and secures ties (also assists
with wraparound)
Describe primary tubing and its components Correct Answers -
Available with either micro- or macrodrip tubing and may have
inline filters, stopcocks, access ports, and shut off clamps
-Components: spike, drip chamber, roller clamp, syringe tip,
locking collar, medication ports
-Distal end: male adapter that is connected to hub of IV catheter
Describe secondary tubing Correct Answers Short piece of
plastic tubing that connects to primary IV tubing for
administering medication
Describe skin complications from ostomies Correct Answers
May be itchy, burning, or painful
Describe some indications for an ostomy Correct Answers -
Congenital abnormalities
-Bladder, colon, and rectal cancer
, -IBD, Crohn's, UC
-Inherited disorders
-Obstruction of ureter
-Stab or GSW to abdomen
Describe the Braden Scale Correct Answers Risk factors
Sensory perception: ability to respond meaningfully to pressure-
related discomfort
Moisture: degree to which skin is exposed to moisture
Activity: degree of physical activity
Mobility: ability to change and control body position
Nutrition: usual food intake pattern (NPO, IV, TPN)
Friction and shear
Scoring
Severe risk: <9
High risk: 10-12
Moderate risk: 13-14
Low risk: 15-18
Discuss causes, description, and treatment for allergic contact
dermatitis Correct Answers Causes: exposure to materials and
chemical compounds that irritate skin (soap, adhesives, etc.)
Description: redness and irritation in area covered or treated
with product
Treatment: alter pouch system or skin care procedure to
eliminate irritating product
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